Untreated sleep apnea presents 'disruptive' dangers to people's lives, including heart issues, says expert

Esther Rodriguez Villegas, a professor at Imperial College London and founder of the London-based medical technology company Acurable, is sharing common health and well-being issues that can result from sleep apnea — a problem that can be disruptive for both sufferers as well as their loved ones.

One of these risks is cardiovascular disease. The sudden and frequent drops in blood oxygen caused by sleep apnea can "put a strain on the cardiovascular system and cause increased blood pressure," Villegas told Fox News Digital in an interview.

"If symptoms persist over a long period of time, this increases the chances of serious cardiovascular problems, such as heart attacks, strokes or abdominal aortic aneurysms, to name a few," she said.

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The "potentially serious" sleep disorder known as sleep apnea causes breathing to stop and start repeatedly during sleep, according to Mayo Clinic’s definition.

Obstructive sleep apnea (OSA) is one type of sleep apnea that occurs when "throat muscles relax and block the flow of air to the lungs," Mayo Clinic explained on its website.

Central sleep apnea (CSA) happens when the brain fails to send proper signals to the muscles that control breathing.

And yet, while sleep apnea can affect anyone, certain factors such as excessive weight and thicker neck circumference, which can cause narrower airways, can increase the risk, according to Mayo Clinic. 

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Older men are at a higher risk of sleep apnea, as well as those who consume alcohol, smoke or use sedatives or tranquilizers.

Increasing evidence suggests that the drops in oxygen are linked to years of reduction in life expectancy, the doctor noted.

Diabetes can be another outcome of sleep apnea, as patients with type 2 diabetes have a "very high" prevalence of OSA, according to Villegas.

"Unfortunately, most don’t know they have obstructive sleep apnea, while recent evidence has demonstrated that untreated disease leads to significantly worse glycemic control — in other words, worse progression of their diabetes," she said.

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Since sleep apnea "severely disrupts rest at night," Villegas warned that the condition can impair energy and concentration levels during the day.

This can result in an increased risk of car accidents, according to the expert.

"The statistics vary, but it is thought that in Europe, for example, untreated sleep apnea is the second leading cause of car accidents," she said.

This lack of energy can also affect school or work performance, which can lead to disciplinary issues or accidents.

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"Children with sleep apnea are often found to underperform at school and are sometimes misdiagnosed with ADHD," said Villegas.

"They are often labeled as aggressive or having behavioral issues, when in fact it is the result of untreated sleep apnea."

People with sleep apnea are also more likely to experience mental health issues, Villegas added, such as low mood, irritability, anxiety and depression.

A frequent symptom of sleep apnea is loud snoring, which is usually a clear warning sign for partners or family members in the home.

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But there are some hidden sleep apnea symptoms that could be overlooked, Villegas warned.

These can include waking up frequently at night; waking in the morning with a headache, dry mouth, or sore throat; or feeling fatigued, irritable or in a bad mood during the day.

Other sneaky symptoms of sleep apnea can include night sweats and erectile dysfunction, Villegas said.

Sleep apnea in children can show up as bad behavior, struggles at school, or sleeping in unusual positions, like with their neck extended.

The most common treatment for sleep apnea is a continuous positive airway pressure (CPAP) machine, which Villegas described as a "mask worn overnight that pushes pressurized air into the windpipe to keep it open while sleeping."

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Alternative treatments include a variety of mandibular advancement devices (MADs), which hold the tongue and jaw in the correct position to prevent airway blockages.

Nose, throat and mouth surgery could also help correct these blockages, Villegas said, while tonsillectomies are common in children.

In many cases, lifestyle changes such as weight loss, reducing alcohol intake and quitting smoking can improve or eliminate symptoms entirely, Villegas said.

Approximately 30 million people have sleep apnea in the U.S. — yet only six million are officially diagnosed, according to the American Medical Association.

For those who believe they may have sleep apnea, Mayo Clinic recommends seeking out a health care provider for examination and treatment.

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Amid Florida measles outbreak, surgeon general lets parents decide whether to send unvaccinated kids to school

Amid measles outbreaks in various parts of the U.S., the Florida surgeon general has issued some guidance to parents regarding kids’ school attendance.

In a letter issued to parents on Friday, Dr. Joseph Ladapo said the Florida Department of Health (FDOH) "is deferring to parents or guardians to make decisions about school attendance."

The letter comes in response to a cluster of measles cases identified at Manatee Bay Elementary in Weston, Florida.

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Typical guidance from the U.S. Centers for Disease Control and Prevention (CDC) is for unvaccinated children who have not had the measles to stay home for up to 21 days in the event of a potential exposure at school. 

"However, due to the high immunity rate in the community, as well as the burden on families and educational cost of healthy children missing school, DOH is deferring to parents or guardians to make decisions about school attendance," Ladapo’s letter stated. 

"This recommendation may change as epidemiological investigations continue."

People who have had the full series of the measles, mumps, rubella (MMR) immunization or who have had a prior infection are 98% protected against the highly contagious virus, the doctor noted.

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Those who do not have immunity have a 90% chance of contracting measles.

"If someone in your household contracts measles, all members of the household should consider themselves exposed and monitor symptoms," Ladapo stated in the letter.

The doctor did recommend that students with symptoms should stay home from school.

Common signs and symptoms of measles include a rash on the face, neck and body; high fever; cough; runny nose; and red, watery eyes. 

"All children presenting with symptoms of illness should not attend school until symptoms have fully subsided without medication," Ladapo advised.

On the Florida Department of Health’s website, two doses of the MMR vaccine are listed among the vaccine requirements for children entering, attending or transferring to public and non-public schools for kindergarten through 12th grade.

Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, was not involved in the FDOH letter but offered his reaction to the guidance.

"The measles vaccine is almost 100% effective at preventing spread, especially if two shots are given," he told Fox News Digital in a phone interview on Friday.

"At a time when there's a resurgence of measles in the world and travel is not restricted, and people are coming into this country with measles, it's extremely important that our children be vaccinated against it."

The current measles outbreak is a time when "individual choice has to give way to public health and community preservation or safety," Siegel said.

While some public health officials may have been "mistaken" about drawing that line with the COVID pandemic, that doesn't automatically mean that it applies to every virus and vaccine, the doctor noted.

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"The problem here is that if kids start going to school unvaccinated against measles, given how contagious it is and how effective the vaccine is, they are putting other children at risk," Siegel said. 

Referring to measles as "the most contagious respiratory virus on the planet," Siegel warned that an unvaccinated person has at least a 90% chance of catching the illness if they enter a room where measles was present up to two hours prior.

The doctor also warned of the severity of the disease, noting that one in five people with measles ends up in the hospital. 

These dangers can be offset by the vaccine, Siegel said.

"This is a great vaccine — extremely important, very safe, tested for decades, and [it] prevents the spread of a dangerous virus that's resurging right now."

Siegel also said he disagrees with Ladapo’s guidance to not require unvaccinated children to stay at home.

Dr. Brett Osborn, a Florida neurosurgeon and longevity expert, also reviewed Ladapo’s guidance. 

He said he disagrees with it as well.

"Measles is not COVID-19," Osborn said in a statement to Fox News Digital. "In fact, measles is one of the leading vaccine-preventable causes of death."

"Measles has been well-controlled by national vaccination campaigns, and we have walled off the disease, in essence, as we have polio."

The doctor noted that "time-tested" vaccines — such as the MMR, oral polio and DTP — have low complication rates, "unlike the COVID vaccine." 

"The more people that are vaccinated, the greater the chances of acquiring a state of herd immunity," Osborn said. "The fact that there has been an outbreak in an elementary school in Weston strongly suggests a lack of herd immunity."

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"Sending unvaccinated children to school amid an outbreak — and inside of the transmissible period — is reckless," he also said. 

"While it is always the parents’ choice whether to vaccinate their children, and whether or not to expose them to the virus directly, decisions should be based on scientific fact."

Osborn hypothesized that the COVID pandemic may have contributed to overall vaccine reluctance.

"Unfortunately, as of the past several years — due to induced vaccine fear, the byproduct of a failed COVID-19 vaccine — vaccination rates generally have decreased," Osborn said. "The result? Viral outbreaks. And measles won’t be the last."

As of Friday, there have been 35 measles cases reported in U.S. states, including Arizona, California, Florida, Georgia, Indiana, Louisiana, Maryland, Minnesota, Missouri, New Jersey, New York City, Ohio, Pennsylvania, Virginia and Washington, according to the CDC.

Fox News Digital reached out to Dr. Ladapo, the Florida Department of Health, the Florida Department of Education, and Attendance Works (a San Francisco-based national initiative that advocates for improved school attendance) requesting comment.

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Was Wendy Williams’ dementia caused by alcoholism? Experts share insights

Former TV talk show host Wendy Williams, 59, was diagnosed with frontotemporal dementia (FTD) and aphasia, which impairs the ability to communicate, in 2023, a representative confirmed on Thursday.

Given Williams’ reported history of alcoholism, experts are speaking out about the potential link between her alcohol abuse and current cognitive issues.

Thursday’s announcement of Williams’ diagnosis came ahead of a new Lifetime documentary — titled "Where Is Wendy Williams?" — that will premiere on Saturday, as her representative aims to "correct inaccurate and hurtful rumors about her health."

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Williams entered a facility in April 2023 to allegedly treat "cognitive issues" reportedly due to alcohol abuse, as her family communicates with her through a court-appointed legal guardian.

"In 2023, after undergoing a battery of medical tests, Wendy was officially diagnosed with primary progressive aphasia and frontotemporal dementia (FTD)," Williams’ care team stated in a press release.

"Aphasia, a condition affecting language and communication abilities, and frontotemporal dementia, a progressive disorder impacting behavior and cognitive functions, have already presented significant hurdles in Wendy's life."

Fox News Digital reached out to Williams' team requesting additional comment. 

Dr. Suzette Glasner, PhD, a psychologist in Los Angeles, California, has not treated or examined Williams but said heavy drinking and alcoholism can cause damage to both white and gray matter in the brain, and over time can lead to deteriorating cognitive functioning, including dementia.

"These neurocognitive impacts are a result of a combination of alcohol’s direct neurotoxic effects, depletion of nutrients in the body, impacts on liver functioning and disruption of communication between nerve cells in the brain," Glasner told Fox News Digital.

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When heavy and chronic alcohol use leads to brain damage, an individual can experience problems with their attention, memory and reasoning, the expert said.

"In many cases, individuals who misuse or are addicted to alcohol and drugs struggle with overlapping chronic medical and psychiatric conditions, and this can make it very challenging to determine the etiology or cause of neurocognitive symptoms such as those observed in Wendy Williams," Glasner said.

Neuropsychiatric symptoms including cognitive impairment are common in Grave’s Disease, an autoimmune disorder Williams has spoken about battling over the years.

"Those symptoms often improve with treatment; however, like other chronic diseases, alcohol or drug use can complicate or interfere with treatment response, making improvements less likely," noted Glasner. 

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Elizabeth Landsverk, M.D., a geriatric and dementia expert in San Francisco, also has not treated Williams but said that substance misuse has been previously linked to cognitive decline. She also noted that the extent of its impact isn’t clear.

"Not enough research has been conducted on the matter to give us precise data," she told Fox News Digital.  

"What has been noted is that alcohol abuse — as well as taking a number of other medications — does increase the risk of developing dementia." 

Brain damage and neurocognitive impacts can occur with heavy drinking in individuals with moderate or severe alcohol use disorders, Grasner said — "so there is a wide variation between individuals in the quantity of alcohol that leads to these neurotoxic effects."

"The specific reasons that some individuals develop alcohol-related dementia whereas others do not are not well understood, so we don't currently have guidelines specifying that if you drink a certain amount, you are likely to experience cognitive impairments," she added. 

Women are generally more vulnerable to the damaging effects of alcohol on the brain and body, Glasner noted, which means the onset can occur at a younger age than it would in men.

"Expert evaluation of the contribution of substance use and other underlying medical conditions such as Grave’s Disease to cognitive symptoms would be very important for Williams to ensure that she receives the right treatments at the right time," Glasner recommended.

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"Often involving a family very closely to evaluate the symptoms and the timing of their emergence relative to alcohol or other substance use can be helpful as part of determining an accurate diagnosis and plan of care," she added.

Abstinence from alcohol is a crucial part of treatment for alcohol-related neurological deficits, noted Glasner.

If the condition is caught in time, abstaining from alcohol can at least partially, if not fully, reverse the symptoms, according to the expert.

While symptoms of FTD can vary depending on what part of the brain is affected, most people with the condition experience some common symptoms, as listed on the Johns Hopkins Medicine website. 

Behavior or personality changes are often the most obvious indicators. These may include public outbursts or socially inappropriate actions.

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People with FTD also tend to have impaired judgment, a lack of empathy and lower self-awareness, Johns Hopkins states. 

This type of dementia is also marked by a reduced ability to understand or formulate language.

People may struggle to remember the names of objects, string words into sentences or even recall the meanings of words they used to know. 

The condition can also lead to agitation, irritability and drastic mood swings.

There is no treatment for FTD other than managing symptoms and educating family members and caregivers, according to Hackensack Meridian Neuroscience Institute in New Jersey.

Some aphasia symptoms can be managed with speech therapy.

"Treatment focuses a great deal on family education," said Reena Gottesman, M.D., a behavioral neurologist at the Center for Brain Loss and Memory Health at Hackensack Meridian Neuroscience Institute, in a press release.

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Approximately 50,000-60,000 people may have FTD, per data from the Alzheimer’s Association, a nonprofit group based in Chicago.

Recently, actor Bruce Willis’ FTD diagnosis brought new attention to the rare condition.

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Alabama providers suspend IVF treatments after state court’s ruling as fertility experts weigh in

A decision from the Alabama Supreme Court has led to a halt in IVF services at some locations and a flurry of protests from providers in the fertility space.

The court ruled on Feb. 16 that under state law, frozen embryos are considered children, stating in the decision that "the Wrongful Death of a Minor Act applies on its face to all unborn children, without limitation."

The decision was in response to two wrongful death cases brought by three couples whose frozen embryos were destroyed in an accident at an Alabama fertility clinic. 

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Justices ruled that an 1872 state law allowing parents to sue over the death of a minor child "applies to all unborn children, regardless of their location."

"Unborn children are ‘children’ ... without exception based on developmental stage, physical location, or any other ancillary characteristics," Justice Jay Mitchell wrote in the ruling.

This includes "unborn children who are located outside of a biological uterus at the time they are killed."

Pro-life advocacy group Live Action reacted to the decision in a statement.

"Each person, from the tiniest embryo to an elder nearing the end of his life, has incalculable value that deserves and is guaranteed legal protection," Lila Rose, president and founder of Live Action, said in the statement.

Fox News Digital reached out to Live Action for additional comment.

In the court's ruling, Chief Justice Tom Parker referenced upholding "the sanctity of unborn life," a phrase that appears in the Alabama Constitution.

"Even before birth, all human beings bear the image of God, and their lives cannot be destroyed without effacing his glory," Parker said in the ruling.

In response to the court's ruling, the largest hospital system in Alabama — the University of Alabama at Birmingham (UAB) — announced on Wednesday that it would be suspending its in-vitro fertilization treatments.

"The UAB Division of Reproductive Endocrinology and Infertility has paused in-vitro fertilization (IVF) treatments as it evaluates the Alabama Supreme Court’s decision that a cryopreserved embryo is a human being," the hospital said in a statement provided to Fox News Digital. 

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"We are saddened that this will impact our patients’ attempt to have a baby through IVF, but we must evaluate the potential that our patients and our physicians could be prosecuted criminally or face punitive damages for following the standard of care for IVF treatments," the statement continued. 

The hospital noted that other components of fertility treatments — "everything through egg retrieval" — remain in place, and only the actual egg fertilization and embryo development are paused.

On Thursday, two additional fertility providers — Alabama Fertility Specialists and the Center for Reproductive Medicine in Mobile, Alabama — both announced that they would be pausing their IVF treatments, according to local reports. 

Dr. Asima Ahmad, co-founder and chief medical officer of Carrot Fertility and a practicing reproductive endocrinologist and fertility specialist based in Chicago, Illinois, shared her opinions on the ruling. 

"Access to IVF is now at stake in Alabama due to the recent ruling from the Alabama Supreme Court," she said in a statement to Fox News Digital.

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"This decision could have serious consequences for people who are desperately seeking to have children, including clinics shutting down, doctors moving out of the state for fear of practicing, pricing increases, and changes in medical practice to avoid lawsuits, which might not be ideal for the patient."

Ahmad warned that the ruling could result in "profound damage" to fertility care access.

"As physicians, it is our fundamental duty to do no harm, and this could take away our ability to practice medicine in a way that we think is most ethical and safe for our patients," she added.

Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, reacted to the ruling’s impact on IVF availability in an interview with Fox News Digital.

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"IVF is a crucial part of reproductive science and allows women to have children who otherwise couldn't," he said.

"Freezing eggs is an important part of the process, because it allows women to utilize these eggs later on when the timing is better or when they have found the right partner."

Freezing embryos also allows a couple more options in terms of timing, Siegel said, which may increase the chance of a viable child.

"It is important that a frozen embryo not be used casually or frozen without plan for use, but I believe that IVF is an important option that brings children to couples," he said.

"Certainly, if your religious beliefs indicate that life begins at conception, or in forming an embryo, than you should abstain," he added. "For others, it is an important option."

Approximately 13.4% of U.S. women between the ages of 15 and 49 experience infertility, according to the Centers for Disease Control and Prevention (CDC).

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Women get more benefit from exercise than men, study finds: ‘More to gain’

When it comes to reaping the rewards of exercise, women may have a leg up.

A new study published in the Journal of the American College of Cardiology found that females may get more benefits than men when doing the same amount of physical activity.

Researchers from the Smidt Heart Institute at Cedars-Sinai in Los Angeles analyzed the physical activity data of 412,413 U.S. adults.

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The participants all responded to the National Health Interview Survey database between 1997 and 2019, providing details about the frequency, duration, intensity and type of physical activity, according to a press release from the hospital.

In terms of cardiovascular exercise, the researchers found that men gained their maximum "survival benefit" from doing "moderate to vigorous aerobic physical activity" for about five hours per week.

For women, that same level of benefit was achieved after just 2½ hours of that exercise intensity per week.

Women continued to gain more benefits after that time, however.

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Examples of "moderate to vigorous aerobic physical activity" include brisk walking or cycling, the study detailed.

For strength training exercises, men hit their maximum benefit from three weekly sessions, while women achieved the same outcome with just one session per week.

"We found not only that progressively greater amounts of physical activity reduced mortality risk, but also that the amount of regular exercise needed to achieve the same degree of risk reduction was different in females versus males," said senior author Susan Cheng, M.D., MPH, director of the Institute for Research on Healthy Aging in the Department of Cardiology in the Smidt Heart Institute.

"In effect, women did not need to exercise for as much time as men to achieve the same benefit," she told Fox News Digital. 

"Put another way, for a given amount of time and effort put into exercise, women had more to gain than men."

Co-lead author Martha Gulati, M.D., director of preventive cardiology in the Department of Cardiology at the Smidt Heart Institute at Cedars-Sinai, noted in the release that women have historically and statistically lagged behind men in engaging in exercise.

"The beauty of this study is learning that women can get more out of each minute of moderate to vigorous activity than men do," Gulati said. 

"It’s an incentivizing notion that we hope women will take to heart."

While mortality risk decreased for all adults, it was reduced by 24% for women and 15% for men, according to Cheng.

"We hope that the results of this study will help to motivate females who are not currently engaged in regular physical activity to understand that they are in a position to gain substantial benefit, technically even more than their counterpart males, for each increment of regular exercise they are able to invest in their longer-term health," Cheng told Fox News Digital. 

"Part of what makes females and males different is that when it comes to living longer and living healthier, different types of investments are linked to different types of gains." 

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The researchers hope that these findings will help women who may feel too busy or too intimidated to take on a new exercise routine without feeling that they have to compare themselves to men.

"They can be on their own path to success and every bit of progress will count," Cheng said.

Chris Pruitt, a certified personal trainer with the American Sports and Fitness Association (ASFA) who is based in Maryland, was not involved in the study but said it aligns with observations that women and men may require different approaches to achieve similar health outcomes.

"In my experience, individual responses to exercise can vary widely, and it's fascinating to see this backed by research," he told Fox News Digital. 

"Biological differences between genders, including hormonal variations and body composition, likely play a significant role in these observed differences," Pruitt went on. 

"Women may use energy or recover from exercise differently than men, leading to these distinct benefits from less exercise."

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This research illustrates the importance of personalized fitness programs that consider gender differences, he said.

"It suggests that fitness advice should be more tailored to the individual's goals and abilities and their gender-specific physiological responses to exercise."

The chief limitation of the study is that all physical activity data was self-reported — which creates the possibility for inaccuracies.

"In the future, direct measures of exercise could be analyzed using wearable devices," Cheng said. 

"A very large study of people whose exercise is digitally tracked and measured could one day give us even more detailed information on differences not only between women and men, but also within women and within men."

"There is still a lot more work we need to do to figure out how to best tailor exercise recommendations to each individual person to best meet their individual needs."

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Josh York, founder and CEO of the New York-based fitness training company GYMGUYZ, reviewed the study and said he does not think the findings should influence people's fitness routines.

"There are a lot of things you need for good health and fitness, including proper nutrition and a healthy lifestyle," he told Fox News Digital.

"There are a lot of different variables at play when it comes to assessing a person’s exercise needs and requirements."

While the study looked at maximal survival benefit, York noted that some people might be motivated by other goals, such as looking a certain way.

"At the end of the day, exercise doesn’t discriminate, no matter your gender," he said. "You have to put the work in to be healthy. If someone puts more work in, has a healthy diet and lives in a safe environment, they are going to get better results, because physical health is influenced by your habits and mental well-being."

As each individual is different, York said that "sweeping assumptions" about each gender’s exercise needs and outcomes don’t take into account variations in individuals’ circumstances.

"I don’t think people should use this as guidance to reduce their exercise regimens," he said.

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‘COVID paralyzed my diaphragm’: Marathon runner shares how the infection took his breath away

Someone with COVID-19 might expect to experience fatigue, cold and flu symptoms, and loss of taste and smell — but a paralyzed diaphragm would likely not be on the radar.

It was certainly a surprise to Gerald Branim, 55, a runner from Tennessee. His life took a drastic turn when COVID-19 damaged his lungs and diaphragm to the extent that he was unable to run or walk for a year.

Branim and his doctor, Matthew Kaufman of the Institute of Advanced Reconstruction in New Jersey, joined Fox News Digital in an interview to discuss Branim’s ordeal and recovery.

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When Branim got COVID in Feb. 2021, he was a fit, healthy 52-year-old who ran marathons. 

In spite of that, the infection caused significant lung damage. He spent two weeks in the hospital and three months out of work.

For two months after leaving the hospital, Branim used a walker as he continued struggling with lung complications.

"For someone who had run marathons, it was quite humbling to have to walk with a walker for three months," he said.

After rounds of high-dose steroids and lots of antibiotics, Branim’s chest X-rays finally showed that his lungs had cleared — but he was still having trouble functioning.

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"I still couldn’t go upstairs without my oxygen dropping severely," he recalled. "I couldn't run 100 yards without my oxygen dropping into dangerous levels. I was severely out of breath."

"That's when they started saying something else was going on — that this shouldn't be happening."

After 10 months of not being able to walk or run, Branim’s condition was finally diagnosed via a "sniff test," which is also called a chest fluoroscopy or a video chest X-ray, where the patient is asked to breathe in and out. 

Any paralysis will show up on the scan, as the diaphragm won’t move upon breathing.

Diaphragm paralysis — which is a "pretty rare condition," according to Kaufman, Branim's doctor — is paralysis of the diaphragm muscle, which is the primary breathing muscle. 

Previous studies have estimated that the condition affects only about 1.31% of the population. In about 95% of cases, only one side is paralyzed, the doctor noted.

"We have two diaphragms, one on the right, one on the left," he said.

In cases where both sides are paralyzed, symptoms will be much more severe, usually requiring the patient to be put on oxygen.

"It’s become sort of a phenomenon," Kaufman told Fox News Digital. "The phrenic nerve, which is the nerve that controls the diaphragm, seems to be an area where the COVID virus can have an impact."

In some ways, he said, the condition can be considered part of long COVID, which is when symptoms of the virus linger for weeks, months or even years after infection.

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Most people with diaphragm paralysis won’t have difficulty breathing while sitting. Symptoms will typically emerge with exertion, such as walking or exercising, or when changing positions, such as lying flat in bed or bending over to tie their shoes, Kaufman said.

Some people are more susceptible than others, the doctor noted.

"We know that viruses tend to attack nerves in the body, as we’ve seen in Bell’s palsy," he said. "And now we’re seeing it with COVID causing injury to the phrenic nerve."

Because the condition is rare to begin with, he said, it’s not something that’s universally known.

"And then you take a condition like COVID, which causes respiratory symptoms from inflammation in the airways and lungs, and then you tie in what we consider to be a neuromuscular problem," Kaufman said.

"A lot of times, the physician or patient will attribute it to airway inflammation, when in fact it's a problem related to nerves and muscles that are part of the respiratory system."

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In some cases, patients will recover on their own, Kaufman said.

"We usually recommend a period of about six to 12 months of physical therapy, breathing exercises and cardiovascular fitness to try to see if this will come back on its own," he said.

If improvement is not noticed in that time frame, surgical intervention becomes a possibility.

In 2020 and 2021, Kaufman said he saw an uptick of patients who experienced diaphragm paralysis after having COVID. Although he is still seeing some cases, they are starting to trail off a bit.

"That could be because the classic COVID is not as virulent or severe," he said. "Or maybe it’s because more people are immunized."

Although the condition is generally not life-threatening, it can be more severe in patients who have existing respiratory conditions.

After Branim’s diagnosis, his lung doctor advised him to continue to give it time to heal.

"But it wasn’t getting any better," he said. "And I just wasn't satisfied with that being my new quality of life."

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That’s when Branim turned to Google to research surgical options. He came across an article by Kaufman, a plastic and reconstructive surgeon who specializes in an area called peripheral nerve microsurgery.

Kaufman specializes in conditions that cause either pain or paralysis due to nerve damage of the peripheral nervous system. 

After meeting with Kaufman in a telehealth visit, Branim was identified as a prime candidate for the surgery, which is called phrenic nerve reconstruction. 

If he had waited much longer, he said, his diaphragm muscle would have atrophied and the surgery would no longer have been possible.

After a lot of back and forth with the insurance company, Branim finally got the green light to travel from Nashville to New Jersey for the procedure.

The surgery went smoothly, although Branim was told that it wouldn’t be an immediate improvement. Once the nerve is fixed, the muscle still needs time to strengthen and rehabilitate.

"Dr. Kaufman told me that it would probably take a year or two to recover fully, and was preaching patience — but I'm not a patient man in the slightest sense of the word," Branim laughed.

He set a goal of running a half-marathon within a year of his surgery date.

After four weeks, Branim slowly began exercising again. After six months, he decided to lace up his running shoes and give it a try.

"My very first run after the surgery, I ran five miles," he said. "I literally cried. At that point, it was like a light switch had been flipped."

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Within six months, Branim had not only regained his ability to run, but exceeded his original goals, culminating in a half-marathon in April 2023.

In a triumphant twist, Kaufman, who is also a runner, joined his patient in completing the race in Asbury Park, New Jersey.

Now, Branim aims to raise awareness about diaphragm paralysis, an often-overlooked condition that is not on most doctors’ or patients’ radars.

"None of my doctors had even heard of this surgery," he said. "Had I not found the article about Dr. Kaufman and another runner online, I would have never been able to have the surgery — and I would absolutely not be running today." 

Branim emphasized the importance of patients serving as their own advocates.

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"Doctors are human — they don't know everything," he said. "So you have to advocate for yourself."

For patients who are experiencing shortness of breath with exertion that persists for several months, Kaufman recommends visiting a primary care physician or pulmonary physician to get the necessary testing.

"While most tests will find more common ailments, it definitely makes sense to keep a paralyzed diaphragm on the list of things to rule out."

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